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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1379727



Case Details

VAERS ID: 1379727 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-28
Onset:2021-06-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pustule, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amitriptyline 25mg, Topiramate 25mg, Sumatriptan 50mg, and Alprazolam 1mg
Current Illness:
Preexisting Conditions: Migraine headache, depression, anxiety
Allergies: no known drug allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s husband reported that patient noticed on 6/4/2021 bumps and itchy rash on her stomach , side of torso, and back (not as prominent on back). Bumps and rash have grown in size and seem pustule and "zit-like". Patient will continue to monitor rash size and temperature. If any drastic changes in temperature or rash size/status, patient will seek medical attention.


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